The Value Of Quantitative Analysis Of Contrast-enhanced Ultrasonography In The Differential Diagnosis Of Benign And Malignant Thyroid Nodules With Rich Blood Supply

Purpose:By quantitatively analyzing the time intensity curve（TIC）parameters of thyroid rich blood supply solid nodules under contrast-enhanced ultrasound,the blood perfusion characteristics of thyroid rich blood supply solid nodules were obtained,and the value of contrast-enhanced ultrasound quantitative analysis in the differential diagnosis of benign and malignant thyroid rich blood supply solid nodules was discussed.Methods:In this study,714 patients who underwent contrast-enhanced ultrasonography in our hospital from June 2020 to October 2021 were selected.For multiple nodules,the nodules with the highest ACR ti-rads score were selected for contrast-enhanced ultrasonography.There were 62 cases of solid nodules with the size of 0.5-1cm and equal or high enhancement（rich blood supply）on contrast-enhanced ultrasound.The pathological results obtained by cytological or histological examination confirmed that there were 30 cases of benign nodules and 32 cases of malignant nodules,all of which were thyroid papillary carcinoma.There were 13 males and 49females,with an average age of 45.5±10.5 years.All contrast-enhanced ultrasound images are stored in the machine and exported in DICOM format.Offline,vuebox^@software is used for quantitative analysis to obtain tic parameters,including PE（peak enhancement）,RT（rise time）,FT（fall time）,TTP（time to peak）,MTTI（mean transit time）,AT（arrive time）,Wi R（wash-in rate）,Wo R（wash-out rate）.Compare the tic parameters between benign and malignant nodules,between nodules and surrounding normal thyroid tissue,and between benign and malignant nodules and surrounding normal thyroid tissue.Draw the ROC curve for the indicators with statistical differences,calculate the area under the curve（AUC）,select the indicators with the highest diagnostic efficiency,and obtain the sensitivity,specificity and threshold of diagnosis.Results:Quantitative analysis:（1）in the comparison of TIC parameters between benign and malignant nodules,the RT,FT,MTTI and TTP indexes of benign nodules were greater than those of malignant nodules,and the Wi R and Wo R indexes of malignant nodules were greater than those of benign nodules,P<0.05.For the above statistically different indicators,draw the ROC curve and calculate the AUC value.The indexes with AUC value>0.7 include RT,FT and TTP.These indexes have diagnostic value.The diagnostic efficiency of RT is the highest,which is 0.794（the diagnostic threshold is 4.77,the specificity is 0.78,and the sensitivity is 0.80）;（2）In the comparison of TIC parameters▲values of benign and malignant nodules,the▲RT,▲FT and▲TTP indexes of benign nodules are greater than those of malignant nodules,and the▲PE,▲Wi R and▲Wo R indexes of malignant nodules are greater than those of benign nodules.Calculate the AUC value.The indexes with AUC value>0.7 include▲PE,▲RT,▲Wi R and▲Wo R.These indexes have diagnostic value;（3）In the comparison of TIC parameters between benign nodules and surrounding normal thyroid tissues,benign nodules had greater PE,Wi R and Wo R than surrounding normal thyroid tissues（P<0.05）;In the comparison of TIC parameters between malignant nodules and surrounding normal thyroid tissues,malignant nodules had smaller RT,FT and TTP and larger Wi R and Wo R（P<0.05）.Conclusion:（1）Compared with benign nodules,malignant nodules showed faster inflow,outflow and reached the peak earlier.（2）Both benign and malignant nodules exhibit higher peak intensity and faster inflow and outflow compared to the surrounding normal thyroid tissue,but malignant nodules exhibit earlier peak attainment relative to the surrounding normal thyroid tissue.